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Liver Metastasis from Colorectal Cancer in the Elderly: Is Surgery Justified?

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Abstract

Background

The elderly population with liver metastasis from colorectal cancer has been increasing. As the potentially curative treatment, the role of liver resection in the elderly remains undetermined.

Aims

This study provides a meta-analysis on the outcome of liver resection of colorectal liver metastasis in patients aged over 70.

Methods

PubMed, Embase, Ovid, Web of Science, and Cochrane databases from the years 2000 to 2015 were searched for eligible studies. Data on perioperative mortality, postoperative complications, and survival were collected.

Results

Twelve retrospective studies with a total of 11,285 patients (2498 elderly patients and 8787 younger patients) were identified. The elderly (>70 years old) were associated with a similar overall complication rate (30.5 vs. 28.0 %; OR 1.08; 95 % CI 0.91–1.28; p = 0.39) and a higher 30-day mortality (OR 1.92; 95 % CI 1.12–3.31; p = 0.02) after liver resection of colorectal liver metastasis (CRLM). The overall survival showed a significant difference in favor of the younger patients (HR 0.76; 95 % CI 0.65–0.89; p = 0.0007). However, with regard to disease-free survival, there was no significant difference between elderly and younger patients (HR 0.93; 95 % CI 0.82–1.06; p = 0.30).

Conclusion

Liver resection of CRLM is relatively safe in carefully selected elderly patients. Liver resection should be offered to selected elderly patients with CRLM.

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Acknowledgments

This study is supported by Guangdong Provincial Scientific Technology Foundation (#B2012149), National Natural Science Foundation of China for Young Investigators (#81200332), and Pearl River S&T Nova Program of Guangzhou (#2014J2200040).

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    Authors and Affiliations

    1. Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, 26 Yuancun Erheng Rd, Guangzhou, 510655, Guangdong, People’s Republic of China

      Minghao Xie, Jinling Zhu, Xiaosheng He, Ping Lan & Lei Lian

    2. Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China

      Minghao Xie, Jinling Zhu, Xiaosheng He, Zihuan Yang, Ping Lan & Lei Lian

    3. Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China

      Zihuan Yang

    4. Department of Preventive Medicine and Biostatistics, Basic Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China

      Xinlin Chen

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    1. Minghao Xie
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    Correspondence to Ping Lan or Lei Lian.

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    Minghao Xie and Jinling Zhu have contributed equally to this work.

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    Xie, M., Zhu, J., He, X. et al. Liver Metastasis from Colorectal Cancer in the Elderly: Is Surgery Justified?. Dig Dis Sci 60, 3525–3535 (2015). https://doi.org/10.1007/s10620-015-3789-3

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    • DOI: https://doi.org/10.1007/s10620-015-3789-3

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